Autor/a:
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Mueller, Natalie; Rojas Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole Hunter, Tom; Dadvand, Payam; Donaire González, David; Foraster, Maria; Gascon, Mireia; Martínez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark J.
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Abstract:
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BACKGROUND: By 2050, almost 70% of people globally are projected
to live in urban areas. As the environments we inhabit affect
our health, urban and transport designs that promote healthy
living are needed. OBJECTIVE: We estimated the number of
premature deaths preventable under compliance with international
exposure recommendations for physical activity (PA), air
pollution, noise, heat, and access to green spaces. METHODS: We
developed and applied the Urban and TranspOrt Planning Health
Impact Assessment (UTOPHIA) tool to Barcelona. Exposure
estimates and mortality data were available for 1357361
residents. We compared recommended with current exposure levels.
We quantified the associations between exposures and mortality
and calculated population attributable fractions to estimate the
number of premature deaths preventable. We also modeled
life-expectancy and economic impacts. RESULTS: We estimated that
annually almost 20% of mortality could be prevented if
international recommendations for performance of PA, exposure to
air pollution, noise, heat, and access to green space were
complied with. Estimations showed that the biggest share in
preventable deaths was attributable to increases in PA, followed
by exposure reductions in air pollution, traffic noise and heat.
Access to green spaces had smaller effects on mortality.
Compliance was estimated to increase the average life expectancy
by 360 (95% CI: 219, 493) days and result in economic savings of
9.3 (95% CI: 4.9; 13.2) billion euro per year. CONCLUSIONS: PA
factors and environmental exposures can be modified by changes
in urban and transport planning. We emphasize the need for (1)
the reduction of motorized traffic through the promotion of
active and public transport and (2) the provision of green
infrastructure, which are both suggested to provide PA
opportunities and mitigation of air pollution, noise, and heat. |